Bill > A01462

This bill establishes a mandatory five-business-day response window for private insurers and Medicaid when physicians submit pre-authorization claims for oncology patients' testing or treatments. Specifically, the legislation requires insurers to make a decision and notify the physician within five business days of receiving a pre-authorization claim. If an insurer fails to respond within this timeframe, the physician is automatically authorized to proceed with the recommended lifesaving testing, treatment, or procedure, and the insurer will be financially responsible for covering the cost of care. The bill aims to expedite critical medical care for cancer patients by creating a clear timeline for insurance approval and preventing potential delays that could negatively impact patient outcomes. The law would take effect immediately upon passage, applying to both private insurance companies and Medicaid in New York State.

Business and Industry

https://www.nysenate.gov/legislation/bills/2025/A1462